As the New Year Approaches, a Doctor Reflects on Body and Soul


By Cathy Shufro

Published August 29, 2007, issue of August 31, 2007.
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As the Days of Awe approach, their themes — introspection, forgiveness and, of course, mortality — have undoubtedly started to swirl in many of our minds. But some of us, according to physician and author Sherwin B. Nuland, may have it a bit easier than others. Nuland says that the obligations of the High Holidays become less taxing as we age because older people tend to value shalom bayit — peace in the home — “in the sense of peace in the greater home.”

“It becomes much easier to repair old grudges,” Nuland said, in an interview with the Forward at his home in Hamden, a suburb of New Haven, Conn. “We realize that these grudges are really not of much consequence.” As we increasingly recognize that our lives are finite, he said, we feel motivated to achieve the ideal of reconciliation with others.

The features of this stage of life are of particular interest these days to Nuland, who recently published his tenth book, “The Art of Aging: A Doctor’s Prescription for Well-Being.” The book is a departure for the 76-year-old former surgeon, who also wrote the 1994 National Book Award-winning “How We Die,” which detailed the physiological processes that lead to death. Now, in a book more philosophical than medical, Nuland provides advice on “achieving a kind of harmony with the real circumstances of our lives.”

Some of Nuland’s latest thinking was influenced by another writing project, a biography of Moses Maimonides he wrote for the Nextbook/Schocken Jewish Encounters series. Nuland recognized that the teachings of the medieval physician-rabbi have affected how Jews view the body, even today. Maimonides helped disseminate religious and cultural traditions that place responsibility for health in the individual’s hands.

“The Jewish philosophy has always been that determinations about health and about longevity are not made in some celestial manner — that they are related to nature, to how a person has cared for his or her body during life,” Nuland said. “Christians were more likely to believe that disease occurred because of divine will,” perhaps in retribution for sinful living. “So their primary approach would be toward prayer. Whereas the Jewish approach would be toward activity and innovation” — trying any treatment that might work.

For their inclination to choose care over prayer, Jewish physicians owe a debt to the ancient Greeks. This Greek naturalism was adopted by Maimonides in the 12th century. While the Christians of Maimonides’s time valued the body primarily as a “container of the soul,” the Jews saw a sound body as the foundation for Jewish life; only in good health can one fully attend to God’s commandments. As the Psalms assert, “The dead cannot praise God” (Psalms 115:17).

A healthy body also comes in handy when one must flee antisemites. “I don’t think there’s anything more conducive to the search for good health than this basic insecurity,” Nuland said. “This feeling, though minimized in modern-day America and Western Europe, remains an underlying, almost unconscious sense.”

A related virtue of medicine was that it was a portable profession, and a social equalizer. The peregrinations of the Jews allowed the physicians among them to glean medical wisdom from all the cultures they touched, learning of an herb here, a therapy there.

The cosmopolitan knowledge of well-traveled Jews lent a mystique to Jewish doctors that survives even to this day. Nuland says people may also still have an outmoded (and unconscious) belief that Jews are the least likely doctors to call it quits. “There is still some vague traditional sense that Jews are less willing than other doctors to give up on medical means by turning to prayer early in the course of treatment,” he said.

Nuland believes that the narrowing of our horizons can teach us to focus on the richness of what is still possible, “achieving a kind of harmony with the real circumstances of our lives.” Thus, members of the oldest generation often feel moved to model good behavior for their children and grandchildren. “They feel they should become leaders,” he said, and taking part in organized religion can help them to achieve this. “Many people, including agnostics and atheists of my acquaintance, believe in the power of religion to motivate people for good.”

Preserving health becomes a social responsibility, because “we don’t live for ourselves. We live for others. We are the stars that other people steer by.” Still, even the most religious adherent to dictums for staying healthy can be struck down by a cancer that suddenly proliferates or a heart attack written in the genes. Our control is limited.

Given that we all must die, Nuland says that appreciating what Jews have given to the world can provide some solace. Knowing that history, he said, “helps us feel better about the continuity of the lives we have represented.” We can say to ourselves that, just as our grandparents, parents and teachers passed on this culture to us, “I, too, kept this culture alive.”

Cathy Shufro teaches writing at Yale University.

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